Individualised or liberal red blood cell transfusion after cardiac surgery: a randomised controlled trial.
Autor: | Fischer MO; Normandy University, UNICAEN, CHU de Caen Normandie, Service d'Anesthésie Réanimation, Caen, France. Electronic address: fischer-mo@chu-caen.fr., Guinot PG; Department of Anesthesiology and Critical Care Medicine, Dijon University Hospital, Dijon, France., Debroczi S; Normandy University, UNICAEN, CHU de Caen Normandie, Service d'Anesthésie Réanimation, Caen, France., Huette P; Department of Anesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, France., Beyls C; Department of Anesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, France., Babatasi G; Normandy University, UNICAEN, CHU de Caen Normandie, Department of Cardiac Surgery, Caen, France., Bafi K; Normandy University, UNICAEN, CHU de Caen Normandie, Service d'Anesthésie Réanimation, Caen, France., Guilbart M; Department of Anesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, France., Caus T; Department of Cardiac Surgery, Amiens University Hospital, Amiens Picardy University Hospital, Amiens, France., Lorne E; Department of Anesthesiology and Critical Care Medicine, Clinique du Millénaire, Montpellier, France., Dupont H; Department of Anesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, France., Hanouz JL; Normandy University, UNICAEN, CHU de Caen Normandie, Service d'Anesthésie Réanimation, Caen, France., Diouf M; Department of Biostatistics, Amiens Picardy University Hospital, Amiens, France., Abou-Arab O; Department of Anesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, France. |
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Jazyk: | angličtina |
Zdroj: | British journal of anaesthesia [Br J Anaesth] 2022 Jan; Vol. 128 (1), pp. 37-44. Date of Electronic Publication: 2021 Nov 30. |
DOI: | 10.1016/j.bja.2021.09.037 |
Abstrakt: | Background: Current practice guidelines for red blood cell (RBC) transfusion in ICUs are based on haemoglobin threshold, without consideration of oxygen delivery or consumption. We aimed to evaluate an individual physiological threshold-guided by central venous oxygen saturation ScvO Methods: In a randomised study in two French academic hospitals, 164 patients who were admitted to ICU after cardiac surgery with postoperative haemoglobin <9 g dl -1 were randomised to receive a transfusion with one unit of RBCs (haemoglobin group) or transfusion only if the ScvO Results: The primary outcome was observed for 80 of 80 subjects (100%) in the haemoglobin group and in 61 of 77 patients (79%) in the individualised group (absolute risk -21% [-32.0; -14.0]; P<0.001). There was no significant difference in the secondary outcome between the two groups. Follow-up showed a non-significant difference in mortality at 1 and 6 months. Conclusions: An individualised strategy based on an central venous oxygen saturation threshold of 70% allows for a more restrictive red blood cell transfusion strategy with no incidence on postoperative morbidity or 6-month mortality. Clinical Trial Registration: NCT02963883. (Copyright © 2021 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.) |
Databáze: | MEDLINE |
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